HELP- baclofen for butalbital (fioricet/butalbital), problems questions

[Ne/Neva Eva]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

When I was looking for something else I came across this thread:

https://www.mywayout.org/community/f2...fen-49136.html

There isn't a lot of info there, and I wasn't able to get access to the full report on bac and withdrawal. There is mention of the fact that bac works on GABA A, though. (Funny that the first one indicates that it could have abuse potential because of the fact. Clearly the people have never taken baclofen. Seriously. It is so un-fun it's kind of funny to think about anyone taking it recreationally.)

The following is an oooold thread about ordering online, and some of the info is erroneous, but it's comprehensive and a start. If you google "ordering bac my way out" you can get more recent info.

https://www.mywayout.org/community/f2...ine-35483.html

If you find that you want to continue with baclofen, let's PM about alternatives to the way you buy it. (Did I read that wrong? $89 for 90mg?? You must have written/meant 900mg. I'll check.)

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

(1)

First of here's my update:

Its been roughly 10 days I believe since my FIRST dose of baclofen. I'm definitely feeling better as of yesterday evening finally. Since I just got my Rx for butalbital, I was able to take slightly higher doses of the butalbital, (although in the evening; I was able to return to my typical dose of 300-400mg w/o any trouble), I took 10 mg of butalbital at bedtime, & about 1/3 a "shot" of 80% alcohol, drank over an 45 min period (I've never been dependent upon alcohol; & b/c of the butalbital, I can not drink more than 2 "shots" of anything alcohol (80% per volume) over a 2 hour period w/o extreme nausea w/in 2-5 hours. So I basically did this to help w/ sleep & to not have to take an extra 100-200mg butalbital).

This morning, i'm feeling better than yesterday, aside from slight tiredness. The butalbital seems to be working fine w/ my morning dose of 300 mg two hours before i've written this. I think this is how i'm going to use the baclofen for now, JUST AT NIGHT; after i'm done w/ butalbital for the day.. at VERY low levels, upside though is that i find my buprenorphine (suboxone) dosing--my opiate maintenance Rx--has been much lower w/ the baclofen to no ill effects for the last 5-6 days! Anyway, I'm going to try to return back to lower than

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Thanks for your research, Neva!

& thanks for the tips for searching for baclofen... I didn't know whether or not you guys discuss sources here; since i just stumbled across this site literally a week or so ago! I know at bluelight, there is no source discussion. I will review the everything this afternoon (i'm in Eastern Standard time,err, GMT -4:00 hours)

Ne/Neva Eva wrote:

Did I read that wrong? $89 for 90mg??

SORRY! I meant, $89 for a 90 COUNT, 20mg.. which would come to 1800mg total.

..

...If you have ANY other questions (i know everything is somewhat confusing, in regards to my current situation), please feel free to ask!

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

To Greg:

Greg wrote: Yes we are lucky here in Australia to have decent health care, which some people still whinge about..they have no idea what it must be like in the US.I can't tell you how many times i've often dreamed of emigrating to the UK, Australia, or Canada precisely for healthcare! But, unfortunately, no money... no roots or ties.. etc. I do have immediate family in Germany, i'm 2nd generation born here in the US; but i poorly speak the language & again.. no money; out of a job (& i'm only 27) for close to a year now, w/ very little prospects.

I just HOPE (i don't pray, heh) our President's healthcare plan turns out to be successful once it's fully implemented in Jan 2014! Although, its not single-payer (like in Australia & Canada) or nationalized healthcare (like in the UK)--its more loosely based on the Swiss model; which is effective (better than OUR crappy system, at least), but these "mandate" healthcare models still leave small portions (usually poor individuals) still without coverage.. AND, not to mention, there is a case before our supreme court as we speak that may completely invalidate the whole Obama-universal-healthcare law, and the prospects aren't good either; since its a 4 to 3 ratio on the supreme court, the favor being in the hands of republicans & conservatives, who wish to repeal the whole thing (i have a politics-fetish, in case you haven't noticed, heh).

Everyone likes to say how america has "the best healthcare in the world"--pointing to the fact that rich Saudi princes come here from all over the world to get their healthcare! Well, that's fine & dandy.. but i'd prefer a system that works for all Americans; not just the rich & wealthy foreign nationals! & unfortunately, the US is the largest source of "health tourists" -- going to countries like YOURS and using your tax dollars to get healthcare... all b/c our politicians would rather spend near $1 trillion on military spending & tax cuts & farm subsidies! ..Rather than friggin' HEALTHCARE (or other vital services like affordable higher education)! Our republicans/conservatives make the lib dems of the UK & conservatives of Australia look like socialists (which ain't a dirty word in my mind though).

This country is the the best-in-the-west if your rich; but if you fall anywhere else among the economic spectrum; the US is the worst-of-the-west to live in IMO ~and~ IME. OK SORRY, heh, [gets off soap box]

Greg wrote:

Talk about being in a predicament. I thought something like Valium may have helped, due to it working for alcohol withdrawal, but barbiturate withdrawal must be far worse.

First, yes, usually transition to phenobarbital is used to withdraw from another barbiturate (although butalbital is actually a intermediate-to-long acting barbiturate). And yes, barbiturates are much more dangerous w/ their withdrawal. But, like alcohol, barbs are GABA-A agonists (both of which w/ very little GABA-B affinity).. barbiturates increase the efficacy of GABA at GABA-A receptor sites.. but, alcohol's exact mechanism for increasing binding GABA at GABA-A receptor sites is poorly understood & poorly studied by the medical community (go figure). But basically, in regards to benzos like diazepam (valium).. they bind at different receptor sites than barbiturates do (which bind at CA+, err, calcium ion channels). End result is the same effect, but the interactions between all of them makes cross-tolerance tricky, especially w/ barbiturates since they have hepatic-interactions too, such as CYP450 enzymes which metabolize nearly EVERY psychoactive drug--and as such, can cause either increased/decreased drug efficacy; or shortened/lengthened duration of effects of a certain drug! (as long as that drug metabolized via hepatically, err, by the liver... in plain english)!

Anyway i'd imagine alcohol acts at GABA-A sites similar to benzodiazepines (since benzos alleviate w/d); & i'd imagine that in higher concentrations & in daily users, alcohol "spills over" onto a more barbiturate-type of action and/or pharmacological action.. since phenobarbital is used with those w/ very high tolerance to alcohol. There are more subtle complexities to the pharmacodynamics here, but i'll end the pharmacology lesson

[moglor]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

At what point did the vomiting start? I only feel nauseated about an hour after after accidentally doubling my dose; it only lasts for a couple hours, and even then I rarely vomit. Maybe you just got an unrelated stomach bug, or some combination of the drugs caused some low-grade serotonin syndrome.

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

^Doubtful it was serotonin syndrome; the only meds I took that are serotonergic in the slightest was the baclofen (i only say this b/c GABA-B receptors are "metabotropic" like CB, or cannabis, receptors, dopamine, histamine, & serotonin receptors, so there may be some cross tolerance w/ serotonin.. but there isn't really any interest in human, medical studies on this anyway; where as GABA-A receptors are ionotropic, more similar to to NMDA receptors (which, for example, ketamine antagonizes), *SOME* very few subtypes of serotonergic receptors, & glutamate receptors, which also play a major role in anxiety & GABAergic drugs' & their effects, particularly GABA-A agonists of course). Butalbital--a barbiturate--has no direct affinity for serotonin that i'm aware of. The vomiting started about 1.5 days after my first dose of baclofen; upon vomiting, i stopped the baclofen, & then, for the next ~24 hours I could not stop vomiting. At its peak, 12 hours into the whole ordeal, I was vomiting every 2 hours; then it slowly spaced itself out until I was no longer vomiting, but still had extreme anxiety & tremor.

Although i'll admit some of the symptoms did seem suspiciously similar to serotonin syndrome (have had a minor case of it during my drug using days w/ concurrent use of tryptamines & phenethylamines, i.e., 4-Ho-DiPT--a drug similar to psilocybin, the active indole in "shrooms"--combined with 2c-c, similar to mescaline/peyote but much weaker).

The whole thing was probably a combination of:
A. too much baclofen causing either a hangover effect, overdose effect, or possibly GABA-A receptor down-regulation through *some* unknown mechanism (resulting in a "blocking" effect, either symptomatic or neurological, who knows)...

B. minor barbiturate withdrawal due to a lack of butalbital intake (since on day 1, i took significantly less butalbital due to the beneficial effects of baclofen; but the next day when the vomiting started I couldn't keep my medicine down & was talking about 1/5th my typical dose for 2 days; all in all it was probably 3-5 days of significantly lowered barbiturate-intake, which you're NOT supposed to do.. never ever ever),

I'm saying this in retrospect b/c i'm just now starting to feel "normal" & I can tolerate normal doses of butalbital, w/o any noticeable "blockade" effect; with only 10 mg of baclofen at night AFTER i'm done taking any butalbital for the day (last night was the first time i just took the baclofen ONCE & at night at 10 mg.. since I was able to resume my normal butalbital dosing regime during the day yesterday.. & actually, it seemed to cause more synergy w/ the butalbital this time.. this morning. And so far so good!)

[COSGringo]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

I could see getting pretty sick on baclofen. I have had episodes and that was going up slowly. Certain levels just were bad hurdles for me and I was hurling or dry heaving for hours.
I say it was the baclofen especially jumping up in dose like that.

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

COSGringo wrote: I could see getting pretty sick on baclofen. I have had episodes and that was going up slowly. Certain levels just were bad hurdles for me and I was hurling or dry heaving for hours. I say it was the baclofen especially jumping up in dose like that.

I agree.. mostly the baclofen, plus the barbiturate withdrawal (& subsequent inability to keep down my typical barbiturate dosages). I have been apart of the forum "www.bluelight.ru" for close to 10 years; and there are absolute horror stories from idiot teenagers taking handfuls of baclofen for a "buzz"- experiencing much similar to what i've experienced the next day. Although, I quite naively assumed there'd be some cross tolerance due to my high intake of barbiturates (even though they tend to be just GABA-A selective, they are GABAergic PAM drugs, making them very generalized in their effects. So I wrongfully assumed it may "spill over" over onto other GABA-B receptor activation & i'd be ok w/ 200 mg over 1.5 days!)...

Like I said in my edit in the post above yours, COS...
I overlooked the fact that, even though both GABA -A & -B receptors are on the same GABA receptor complex, the -A receptors are isotropic; while the -B receptors are metabotropic.. basically meaning for all intense and purposes that, there is very little "spill over" & cross tolerant effect; aside from perhaps increased sedative & anxiolytic effects when taken concurrently & assuming there is no mechanism of blockade or superior affinity, be it directly neurological or indirect, (& at *NORMAL DOSES*). This is much different than literal synergetic effects, like drinking + barbiturates; drinking + benzodiazepines, or barbiturates + benzodiazepines (which all act on the same receptor, GABA-A, & their net effect is much higher than if you were to just add the effects of each drug individually together for a linear sum-result!)

[Greg]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Ne/Neva Eva;1337119 wrote: Greg, your point is well taken, but there is a study that shows that baclofen is effective for managing alcohol withdrawal. And another one, maybe, that shows that it lessens the amount of benzo needed. (I read about that one here, I didn't read the actual research.)

I was probably thinking too much in black-and-white about bac for alcohol withdrawal. I have indeed read that study you talk about, and recall baclofen being effective for at least some withdrawal cases. I'm just not sure how well it would work, compared to benzos, for severe withdrawal however, e.g. if someone was a regular 15-20 drink a day alcoholic and suddenly stopped. I would still pick a benzo, but that's just me. I think some of the anticonvulsants have also been found useful in alcohol withdrawal, at least up to a moderate level of dependence.

[COSGringo]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

I agree with both of you. Baclofen has been shown to help with w/d. However I did not trust it completely since I had a seizure once when I dropped very quickly but that was without baclofen.
I think a small dose of benzos will give one some piece of mind and help with the SE's too. I don't think it would hurt.
I never stopped fast. I went from like 15 to 8 to 5 and then eventually none.

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

COS
Certainly, baclofen has shown to help; it helped even for me w/ barbiturate intake. I just overdid it, big time. I definitely would agree that, at least for alcohol, ideally BZP+baclofen would be preferable (or in extreme cases, also small doses of phenobarbital).. they act on two totally different GABAergic receptor sites & thus shouldn't interfere w/ one another, at least in a synergetic sense.

Greg
Yes, anticonvulsants would be effective; but what you said "at least up to a moderate level of dependence" is key- there are many many non BZP (benzodiazepine) & non barbiturate anticonvulsants which affect GABA neurotransmitter levels very differently (or are less understood in their mechanism)- such as valproic acid or even gabapentin (trade name "Neurontin" here in the U.S.), both of which will do little to anything for withdrawal, aside from perhaps warding of seizure activity (if used in conjunction w/ other typical GABAergics like BZP's & barbs in extreme cases).

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Update:

Ok, I believe it is around day 10? And i'm pretty much back to normal.. I've been at 10-15 mg of baclofen at night for the past 3 days (including today, & its noon here) & this is working well. I have been able to go down to 1500mg/day or below of my butalbital w/ no problem during this period (absolutely unattainable before). I feel I could drop more, but to avoid a similar situation as before, I will drop the butalbital more slowly (and concurrently titrating up the baclofen, but at an even slower rate).

During these last 3 nights; I have also been taking roughly 4 mL - 8 mL of ethanol (in the form of roughly 10-20 milliliters, or 0.4-1 oz, of 40% alcohol bourbon; or ~half a shot). It seems the efficacy of the butalbital/barbiturate returned to normal after introducing small amounts of ethanol (b/c before these last 3 days, i was taking the same amount of baclofen for 3 days or so; but still was feeling poor and/or dulled effects)? Makes me wonder if there is some GABAergic interaction that miniscule amounts of ethanol posseses, which inhibits some of the neurological effects of baclofen which possibly "dull" butalbital (or for that matter, all or most GABA-A "positive allosteric modulators"--GABAa PAMs for short--which is what barbiturates are), its just a hypotheses though; and it may be something with my specific neurophysiology/chemistry. & it may very well be a coincidence & i'm just finally "over" my initial baclofen "event."

All I can say though, in retrospect, is was traumatic... and reminiscent of barbiturate withdrawal in some respects; while oddly lacking some notable properties, such as powerful 'anxiogenic' effects (anxiogenic / anxiogenesis = inducing anxiety). Although I most certainly did experience anxiogenesis/anxiousness....

GLAD it seems to be over!

[COSGringo]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Well they are both central nervous system depressants. They say it's a big no no combining those but at least you are drinking very little. You are very low on the baclofen dosage so that's probably the biggest factor.
This barbituate you are taking, does it have acetaminophen in it like Fiorcet? That is really bad for your liver and combining it with alcohol makes it pretty bad overall. You don't want to drink and take things like tylenol.
Not to nag but 1500 mgs of a barb sounds very high but I have limited experience in that realm. At least you are not taking sedabarb or some heavy barb. I would really work on lowering that dose and upping the baclofen dose. I don't think that little you are taking is going to help a whole lot but don't jump up quick. Maybe 10mg per week. Divide it up through the day.

[RedThread12]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Late to the party, here, but some really interesting conversation. I'm not sure what to respond to first, so I'll just give it a go:

#1. From my personal experience I can say that TOO MUCH baclofen causes unrelenting, miserable nausea and vomiting. It happened majorly when I accidentally took my normal days' dosage twice, and has happened a couple of times when I've taken just one additional dose of my 3x/day maintenance level of bac. So that particular issue is in your rear-view mirror, MM, unless at some point you take too much in a day. You'll know immediately that you screwed yourself with your dosage. For me, it's the same feeling, every time. Ears ringing . . . whole body feels electric . . . and then the nausea. ALL totally avoidable by being methodical and accurate with your dosage.

#2. Why would you leave your baclofen dosage to nights, only? Baclofen has a short half-life, which is why all of the recommended titration schedules involve spreading your dosages out through the day in order to keep a somewhat consistent level of baclofen in your bloodstream. If you take the bb during the day and the baclofen at night, therefor giving the baclofen no opportunity to oppose the bb. It makes much more sense to me . . . and if other MWO'ers disagree, please let me know . . . to do a regular, "by the book," upward titration of baclofen. I started, as did Dr. A., with 10mg, 3x/day, for 3-4 days, adding 10-20mg every 3-5 days. I wasn't "rigid" with this, but I certainly made sure that I was within the parameters of what people were doing and writing about.

I'm of the mind-set that baclofen may very well be useful for every addiction. And I do know someone who never participated on this board who successfully used baclofen, and a careful titration protocol under the guidance of his addiction counselor, to come completely off suboxone. So there's another anecdotal story of baclofen success with opiates.

#3. Ummm . . . oh yeah . . . baclofen and benzos. I don't think there's any "final authority" about this. Dr. Levin says that as long as your taking high enough levels of baclofen, you can't get addicted to benzos. Makes sense to me, but not something I want to test. I have, though, taken a 5 or 10mg valium on occasion, and, like Cos says, I don't notice nearly the effect that used to have, but it can be helpful if the anxiety issue raises it's ugly head at some point in the process of figuring out what does and does not work for YOU regarding baclofen.

If I were you, I would read EVERYTHING I could about baclofen . . . Dr. Ameisen's book, the threads here on MWO, escpecially the "Consolidated Baclofen Information" thread, with links to other helpful threads, and just substitute "floricet" for "alcohol." Knowledge truly IS power in this effort that we are all undertaking to save our lives while living in a broken and corrupt medical care system.

I've been taking bac since '09, and seen indescribable stories go by on this board. In the end, with only a couple of exceptional exceptions, the method for the madness is the same. Regular doses of baclofen taken throughout the day with modest incremental upward dosages every 3-4 days, according to YOUR OWN experience and what your body tells you. Over these years I've seen how profoundly "My Way Out" is, literally, that. It's different for every 1.

I really appreciate your posting here with the drunks . . . IMO baclofen will eventually prove to be a common denominator for use with most addictions, and you've made a bit of a landmark connection. Thanks. I also imagine that titrating up on baclofen in regards to any addiction will have similar effects, side effects, etc., as those of us who have used it for alcohol have had. If you go that route, and I can help in any way, feel free to PM me. Wishing you all the best, MM.

[MusiciansMallet]

HELP- baclofen for butalbital (fioricet/butalbital), problems questions

Hi Red! Thanks for your involvement.....

RedThread12 wrote:

Why would you leave your baclofen dosage to nights, only? Baclofen has a short half-life First, I am just now feeling "normal" from my experience of ~2 days of adverse effects--and even traumatic effects--from baclofen, including vomiting for a whole 48 hours (first dose of baclofen was roughly 10 days ago, adverse effects started roughly 7 days ago, slowly peaked at day 6, slowly subsided since then). SO- I'm taking it very very slow.

Although, I have been fine lately; so i am planning on titrating upwards; or adding an extra 5-10mg in afternoon shortly. I'm aware of its extremely short half life, but, there absolutely must be some sort of neurological mechanism that makes some of its effects extend way after it has been eliminated from the body via renal metabolism. (Alcohol has an extremely short half life as well, 0.5hrs at MOST if I remember correctly; yet, you still feel prolonged neurophysiological effects after ethanol has left the body--i.e., effects of down-regulation & up-regulation of some receptor complexes as a result of alcohol's pharmacological effect. So, i'd assume there is something similar going on there w/ baclofen, or at least, i'm assuming so just to be safe & to not repeat ~2 days of vomiting non-stop, forcing me into barbiturate withdrawal!)

I'm of the mind-set that baclofen may very well be useful for every addiction... And I do know someone who....used baclofen, and a careful titration protocol under the guidance of his addiction counselor, to come completely off suboxone. So there's another anecdotal story of baclofen success with opiates.

I can't agree more. Particularly in the morning, I find I do not need suboxone as soon as I get up (since I took the baclofen the night before). & during my "episode" of severe adverse side effects; I was taking around 2-3mg/d of buprenorphine w/o any ill-effects (wish I could say the same of the butalbital, though).

I have, though, taken a 5 or 10mg valium on occasion, and, like Cos says, I don't notice nearly the effect that used to have.

Makes sense. But, although benzos & barbiturates are both GABA-A agonists; they act on completely different receptor sites. err in different ways to be more precise. Benzos are more selective. For example: diazepam, err Valium, binds to GABA-A alpha-1, -2, -3, -5, & -6 subunits, among some 16 known alpha GABA-A subunits (for comparison, the "z-drug" of the nonbenzodiazepine class, zolpidem--err Ambien--binds selectively to the alpha-1 GABA-A subunit only, which is why they cause mainly sedation without nearly as much anxiolytic properties; each subunit expresses different effects).

Conversely, barbiturates actually act by opening chloride channels in GABA-A receptor sites (and at different areas than benzos, & also by acting as GABA-A agonist by increasing efficacy of endogenous GABA in synapses, rather than increasing frequency of GABA binding, such as the case is w/ benzos--hard to explain, i barely understand it myself). Basically barbiturates will bind to most of these subunits in a very non-selective way; while also acting on glutamate receptors, causing even more sedation. Alcohol is even more tricky. Much like baclofen, since its not a patentable drug that pharmaceutical companies can make butt-loads of cash on; its pharmacological intricacies are not well studied. But, alcohol is a GABA-A agonist, & is more broadly acting--which is probably why detox uses benzos in some instances, but phenobarbital in instances of very high tolerance.

Now only if GABA-A were as simple as GABA-B receptors (baclofen's targeted receptor site)! With that said, I do notice similar "dulling" effects w/ my butalbital as you described with diazepam (although i've never taken benzos & baclofen concurrently). So baclofen probably has some sort of unknown, additional mechanism that inhibits GABA-A agonism to a certain degree (this mechanism is probably indirect in nature, since its known that baclofen is very selective for GABA-B & isn't cross tolerant at -A receptors). Anyway, sorry, its hard to keep back my fetish for pharmacology, heh.. i'm done (for now)

I really appreciate your posting here with the drunks . . . IMO baclofen will eventually prove to be a common denominator for use with most addictions, and you've made a bit of a landmark connection. Thanks. I also imagine that titrating up on baclofen in regards to any addiction will have similar effects, side effects, etc., as those of us who have used it for alcohol have had. If you go that route, and I can help in any way, feel free to PM me. Wishing you all the best

Thanks! And I chuckle at your comment- "posting w/ drunks"... heh heh. For me, I see the distinction between those dependent upon alcohol relative to those dependent on barbiturates or benzodiazepines as arbitrary. Look at opiates/opioids for example? They have differing binding affinity at different opioidergic receptors (such as delta- & kappa- opioid receptors; even though mu-opioid receptors are most responsible for their psychoactive effects). Even though the opioidergic complex is not even nearly as intricate as the GABAergic complex, the end result (being the psychological response) between different opioids/opiates is similar to the arbitrary differences between the psychological responses between different GABA-A agonist substances (IMO at least)! So, its not like those dependent upon diacetylmorphine (heroin) need to seek different support groups than those who're dependent upon oxycodone or methadone (the latter of which acts on a whole host of areas- NMDA antagonist, like ketamine, being the most notable). So I just see it as arbitrary to distinguish a fundamental difference between dependencies on unrelated opioids/opiates; and I apply this same concept to GABAergics like alcohol & barbiturate dependency (they all do have the same end psychoactive result after all, albeit with subtle differences; just like the subtle differences w/ opioids), but that's just me!

And, by the way, I really appreciate (and am very surprised) as to the outreach in response to my post! I'll definitely take ya up on that offer if needed! And also, thanks very much for your well-wishes. & i will check out the threads you recommended. I most certainly will continue w/ baclofen; like I said, i am just taking it very very slow now b/c of my initial bad experience.